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Milk Thistle | | |
Milk thistle is one of the most powerful natural liver protector's known
to man. It is one of the best examples of preventative medicine that we
have today as it not only protects each cell of the liver from incoming
toxins, but simultaneously encourages the liver to cleanse itself of
damaging substances, such as alcohol, drugs, medications, mercury and
heavy metals, pesticides, anesthesia, and even the most poisonous of
mushrooms, the amanita or "death-cap" mushroom.
The
scientific support for this 2000-year-old liver remedy is substantial, and
evidence within animal, in vitro, and human clinical trials is strong.
Considered a noxious or invasive roadside perennial weed in many
horticultural circles, milk thistle is wonderful and appropriate for
anyone who is under stress, uses alcohol, recreational drugs, prescription
medications, or lives in today's modern times of pesticides, environmental
toxins, and pollution - virtually everyone!
| |
| Common Name | | | Milk Thistle
| | | Botanical Latin Name / Classification | | | Carduus marianus, Silybum marianum
| | | Parts Used | | | Fruits (referred to as seeds), herb
| | | Other Names | | | Cardui mariae, Carduus marianum, Holy Thistle, Lady's Thistle, Legalon,
Marian Thistle, Mariendistel, Mary Thistle, Our Lady's Thistle,
Silimarina, Silybin, Silybum marianum, Silymarin, St. Mary Thistle.
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| | | Description | | | Milk thistle, a member of the aster or daisy family, is an herbaceous
annual or biennial plant with a dense prickly flower head consisting of
purple tubular flowers. The fruit of the milk thistle plant is brown and
spotted with white tufts of hair. The ripe seeds of the fruit are the
medicinal part of the plant but virtually all parts of the plant have been
used as food with no known toxicity.
Milk thistle grows throughout
the world (including North America) in both cultivated and wild form. Many
sources refer to the herb, by its botanical name, Silybum marianum, as
well as by its active compounds, collectively known as silymarin.
Concentrated stores of silymarin are found in the herb's shiny black
fruits (seeds), which are typically collected at summer's end.
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| | | Traditional Internal Uses | | | Medical use of milk thistle can be traced back more than 2,000 years.
Nicholas Culpeper, the well-known 17th-century pharmacist, cited its use
for opening "obstructions" of the liver and spleen and
recommended it for the treatment of jaundice.
Traditionally, milk
thistle fruits have been used for disorders of the liver, spleen and gall
bladder such as jaundice and gall bladder colic. Milk thistle has also
been used for nursing mothers for stimulating milk production, as a bitter
tonic, for hemorrhoids, for dyspeptic complaints and as a demulcent in
catarrah and pleurisy. It is stated to possess hepatoprotective,
antioxidant and choleretic properties.(1,2)
Current interest is
focused on the hepatoprotective activity of milk thistle and its use in
the prophylaxis and treatment of liver damage and disease.
The
leaves have also been used for the treatment of liver, spleen and gall
bladder disorders and as an antimalarial, emmenagogue and for uterine
complaints. Milk thistle leaf preparations are available today, although
most research has been conducted with preparations of the fruit since the
leaf does not contain the pharmacologically active component
silymarin.
Although most widely associated with liver complaints,
milk thistle is also being examined for treating a variety of other
disorders, from gallstones and high cholesterol to skin cancers and
allergy symptoms. As a potent antioxidant, the versatile milk thistle
extract helps prevent highly reactive oxygen molecules called free
radicals from damaging cells throughout the body, but especially in the
liver, stomach, and intestines.
An injectable form of milk thistle
is a powerful antidote to mushroom poisoning. And the oral extract shows
promise for minimizing chemotherapy-associated liver damage. This is a
function of the herb's antioxidant actions as well as its ability to
accelerate the excretion of toxic compounds that can accumulate in the
body.
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| | | Traditional Topical Uses | | | Milk thistle is rich in the essential moisturizers and fatty acids making
it useful for dry skin needs. Topical milk thistle is often used for mild
skin irritations due to its anti-inflammatory effects. In research
studies, silymarin, applied to the ears of mice with dermatitis, caused a
decrease in inflammation. The antioxidant, free-radical scavenging, and
regenerative properties of milk thistle make it a useful component in
creams and skin formulations.
Since many health practitioners
believe that some skin disorders, such as psoriasis, are the result of a
"sluggish liver", it is no surprise that milk thistle is
recommended for these conditions with both internal and external
applications.
Milk thistle may one day prove to be an important
weapon in the battle against skin cancer. Researchers at Case Western
Reserve University in Cleveland found that when the active ingredient,
silymarin, was applied to the skin of mice, 75% fewer skin tumors resulted
following exposure to ultraviolet radiation. More studies are needed to
see if it has a similar effect in humans.
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| | | Indications | | | Primary Indications: Liver Disease (Alcohol-Related), Liver Disorders, Cirrhosis, Jaundice, Gallbladder Disorders, Hepatitis, Gallstones, Hypercholesterolemia, Toxicity / Toxemia
Secondary Indications: Indigestion, Dyspepsia, Constipation, Gastrointestinal Disorders, Immunity / Immune Disorders
Other Indications: Skin Disorders, Psoriasis, Skin Cancer / Skin Ulcers, Eczema (Dermatitis), Kidney Disorders, Spleen Disorders, Food Allergies / Sensitivities, Seasonal Allergies / Hay Fever, Alzheimer's Disease, Schizophrenia, Edema (Dropsy), Depression
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| | | Actions | | | Anti-Carcinogenic, Anticancer / Antitumor, Antidepressant, Antihepatotoxic, Antimalarial, Antirheumatic, Cholagogue, Depurative, Diuretic, Emmenagogue, Hepatoprotective, Laxative
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| | | Constituents / Nutrients | | | Fruit
Flavolignans: 1.5-3% silymarin, a
mixture containing approximately 50% silibinin (= silybin, silybinin),
silichristin and silidianin, as well as silimonin, isosilichristin,
isosilibinin, silandrin, silhermin, neosili hermins A and B,
2,3-dehydrosilibinin and tri- to pentamers of silibinin
(silybinomers).(1)
Flavonoids: Quercetin, taxifolin
and dehydrokaempferol.(1)
Lipids: 20-30% Linoleic
acid, oleic acid and palmitic acid.
Sterols:
Cholesterol, campesterol and stigmasterol.
Other
Constituents: Mucilages, sugars (arabinose, rhamnose, xylose,
glucose), amines and
saponins.(1)
Leaves
Flavonoids:
Apigenin, luteolin and kaempferol and their
glycosides.(1)
Other Constituents: ß-Sitosterol
and its glucoside, and a triterpene acetate.(1)
Silymarin is not
found in the leaves.
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| | | Pharmacological Summary | | | The chemistry of milk thistle is well-documented and there is good
evidence that silymarin and its components, particularly silibinin, are
responsible for the pharmacological effects.
Documented scientific
evidence from in vitro and animal studies provides supportive
evidence for some of the uses of milk thistle, particularly those relating
to hepatoprotective properties.
There have been several controlled
clinical trials investigating the effects of milk thistle in a range of
liver disorders, including acute viral hepatitis, chronic hepatitis,
alcoholic liver disease, cirrhosis and toxic liver damage. The results of
these studies are not entirely consistent or conclusive. In addition, some
trials have methodological shortcomings, for example the inclusion of
patients with different liver disorders, small numbers of patients and
failure to control or monitor alcohol intake.(67) Further, well-designed,
clinical trials in clearly defined patient groups are required in order to
establish the efficacy of milk thistle and its components in different
liver disorders. In Germany, milk thistle is approved for the treatment of
toxic liver disorders and as a supportive treatment in chronic
inflammatory liver disease and hepatic cirrhosis.
Teas prepared
from milk thistle fruits or herb are not commonly used as only a small
proportion of silymarin gets into the aqueous extract such that
pharmacologically active doses are not attained.(68) For this reason, in
Germany teas are recommended only as supportive treatment in functional
gall bladder disorders and not for antihepatotoxic effects. In Germany,
milk thistle fruit (3-5 g) as an infusion three or four times daily is
also indicated for mild digestive disorders.
There are some
toxicity and safety data for milk thistle which, together with data on the
adverse effects reported in clinical trials, provide good evidence for the
safety of milk thistle when used at recommended doses in the short term.
However, further data on the long-term safety of milk thistle use are
required.
Patients wishing to use milk thistle should be advised to
consult a pharmacist, doctor or other suitably trained healthcare
professional for advice.
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| | | Scientific Research and Pharmacologicial Actions | | | Silymarin acts as an antagonist in many experimental liver-damage models:
phalloidin and -amanitin (death-cap toxins), lanthanides, carbon
tetrachloride, galactosamine, thioacetamide, and the hepatotoxic virus FV3
of cold-blooded vertebrates.
The therapeutic activity of silymarin
is based on two sites or mechanisms of action:
(a) It alters the
structure of the outer cell membrane of the hepatocytes in such a way as
to prevent penetration of the liver toxin into the interior of the
cell;
(b) It stimulates the action of nucleolar polymerase A,
resulting in an increase in ribosomal protein synthesis, and thus
stimulates the regenerative ability of the liver and the formation of new
hepatocytes.
Several pharmacological activities have been
documented for milk thistle fruit, including hepatoprotective,
antioxidant, anti-inflammatory, antifibrotic and antitumour properties, as
well as inhibition of lipid peroxidation, stimulation of protein
biosynthesis and acceleration of liver regeneration. Silymarin (an isomer
mixture comprising mainly silibinin, silichristin and silidianin) is the
pharmacologically active component of milk thistle fruit; silibinin is the
main component of silymarin. There is an extensive literature on the
pharmacological effects of silymarin and silibinin, particularly with
regard to their hepatoprotective activity which provides supporting
evidence for the clinical uses. The pharmacology and clinical efficacy of
milk thistle have been reviewed.(1-3) The following represents a summary
of selected publications on this subject.
There is a lack of
research investigating the pharmacological effects of preparations of milk
thistle leaf.
In Vitro and Animal
Studies
Antioxidant Activity
Silymarin and
silibinin (silybin) are antioxidants that react with free radicals (e.g.
reactive oxygen species) transforming them into more stable and less
reactive compounds.(1,4-6) Silymarin and silybin have been reported to
inihibit lipid peroxidation induced by iron-linked systems in rat liver
microsomes(7,8) and protect against phenylhydrazine-induced lipid
peroxidation in rat erythrocytes.(1) Furthermore, in rats, intraperitoneal
silymarin has been shown to increase total glutathione in the liver,
intestine and stomach and to improve the reduced glutathione to oxidised
glutathione ratio.(9) Silymarin has been shown to inhibit copper-induced
oxidation of human low-density lipoprotein (LDL) in vitro in a
concentration-dependent manner.(10) Silybin appears to be the constituent
of silymarin responsible for the LDL antioxidant effect. In contrast,
silichristin and silydianin appeared to act as pro-oxidants, but without
significantly reducing the total LDL antioxidant capacity of
silymarin.
Free radicals are recognised as having an important role
in several pathological processes, including inflammation, necrosis,
fibrosis, atherosclerosis, carcinogenesis and ageing and in the
hepatotoxic mechanisms of various substances. The antioxidant activity of
silymarin is thought to contibute to its hepatoprotective
properties.(11)
Hepatoprotective
Properties
In vitro studies using isolated
hepatocytes have documented the protective activity of silymarin and
several of its components against cell damage induced by various cytotoxic
substances.(1)
In vivo studies in rats and mice have
demonstrated the hepatoprotective activity of silymarin and silybin in
acute liver toxicity induced by various toxic agents with different
mechanisms of action, including carbon tetrachloride, galactosamine,
thioacetamide, ethanol, paracetamol (acetaminophen), thallium, phalloidin
and α-amanitin (the main toxic constituents of the mushroom A.
phalloides).(1) Experimental studies in chronic liver toxicity induced by
repeated administration of carbon tetrachloride, heavy metals,
thioacetamide and several drugs, including azathioprine and indometacin,
have also demonstrated that administration of silymarin and silybin
protects against damage.(1) Other studies have reported protective effects
of silymarin against liver injury induced by ischaemia(12) and gamma
irradiation.(13)
Studies in rabbits fed a high-fat diet for 12
weeks have shown that histopathological alterations were least advanced in
animals which also received a silymarin-phospholipid complex.(14) In rats,
silymarin inhibited the development of diet-induced
hypercholesterolaemia.(15) The hypocholesterolaemic effects of silymarin
may be due to the effects of silymarin on lipoprotein
metabolism.(16)
The effects of silymarin on biliary bile salt
secretion have been seen in studies in rats.(17) Intraperitoneal silymarin
(25, 50, 100 and 150 mg/kg/day) for five days induced a dose-dependent
increase in bile flow and bile salt secretion. Stimulation of bile salt
secretion was mainly accounted for by an increase in the biliary secretion
of the hepatoprotective bile salts ß-muricholate and
ursodeoxycholate.
Nephroprotective Properties
Silibinin injected into rats prior to administration of cisplatin
afforded protection of glomerular and proximal tubular function.(18,19)
Silibinin does not affect the cytotoxic activity of cisplatin.(19)
Intraperitoneal silibinin (5 mg/kg) administered to rats 30 minutes before
ciclosporin decreased ciclosporin-induced lipid peroxidation but produced
no protective effect on the glomerular filtration
rate.(20)
Anticancer Activity
Silybin at
concentrations of 0.1-20 µmol/L inhibited the growth of drug-
resistant ovarian cancer cells and doxorubicin- resistant breast cancer
cells in vitro.(21) Furthermore, silybin in the range of 0.1-1.0
µmol/L potentiated the effect of cisplatin and doxorubicin in
experimental tumour cell lines. When applied to the skin of SENCAR mice,
silymarin gave protection against the effects of the tumour promoters
12-O-tetradecanoylphorbol (TPA) and okaidic acid (OA).(22) Topical
application of silymarin prior to that of TPA and OA completely inhibited
induction of tumour necrosis factor α (TNFα) mRNA expression
in the epidermis. Substantial protection from photocarcinogenesis in mice
treated with phorbol ester or 7,12-dimethylbenz(a)anthracene has been
demonstrated.(23) The antitumour effect is primarily at stage 1 tumour
promotion and silymarin acts by inhibiting cyclo oxygenase 2 (COX-2) and
interleukin 1α (IL-1α).(24) Such effects may involve
inhibition of promoter-induced oedema, hyperplasia, the proliferation
index and oxidant state.(25)
Treatment of serum-starved human
prostate carcinoma DU145 cells with silymarin resulted in significant
inhibition of transforming growth factor α (TGFα)-mediated
activation of the epidermal growth factor receptor erbB1.(26) There was
also a decrease in tyrosine phosphorylation of an immediate downstream
target, the adaptor protein SHC, together with a decrease in binding to
erbB1. In the silymarin-treated cell lines there was a significant
induction of the cyclin-dependent kinase inhibitors (CDKIs) Cip1/p21 and
Kip/p27 concomitant with a significant decrease in CDK4 expression, but no
changes in the levels of CDK2 and CDK6 and their associated cyclins E and
D1, respectively. Additional experiments showed that there was a
significant inhibition of constitutive tyrosine phosphorylation of both
erbB1 and SHC, but no changes in their protein levels. The results
indicated that silymarin may exert a strong anticarcinogenic effect
against prostate cancer and that this effect is likely to involve
impairment of the erbB1-SHC-mediated signalling pathway, induction of
CDKIs and resultant G1 arrest.(26)
There was a significant
inhibition of mitogen-activated protein kinase (MAPK) ERK activity at
lower doses in epidermal A431 cells treated with silymarin, whereas higher
doses activated MAPK/JNK1.(27) Silymarin exerted a strong anticarcinogenic
effect against human breast carcinoma cells MDA-MB468 with G1 arrest in
cell cycle progression and also induction in protein expression of the
CDKI Cip/p21.(28)
The cancer chemoprevention and anticarcinogenic
effects of silymarin have been shown to be due to its major constituent
silibinin.(29) Silibinin decreases prostate-specific antigen (PSA) in
hormone-refractory human prostate carcinoma LNCaP cells and inhibits cell
growth via G1 arrest.(30)
Silibinin was fed orally to SENCAR mice
and its tissue distribution investigated.(31) Free silibinin mainly
accumulated in the liver, although it was also distributed in other
organs. Increases in glutathione-S-transferase and quinone reductase
activities in the liver, lung, stomach, skin and small bowel were
observed. The results demonstrated the bioavailability of and phase II
enzyme induction of silibinin in different tissues where silymarin has
been shown to be a strong cancer chemopreventive
agent.
Anti-Inflammatory Activity
Silymarin
administered orally reduced foot-pad abscesses in a dose-dependent manner
in the carrageenan rat paw oedema test (ED50 = 62.4 mg/kg).(32) In the
xylene-induced inflammation test, topically applied silymarin was
comparable with indometacin.(32) Silymarin given intraperitoneally to mice
resulted in inhibition of leukocyte accumulation in inflammatory exudates
and reduced the neutrophil count.(32) Activation of NF-?B induced by TNF,
phorbol ester, okaidic acid and ceramide was blocked by silymarin in a
dose-dependent manner.(33) Silymarin also inhibited TNF-induced activation
of mitogen-activated protein kinase and c-Jun N-terminal kinase.(33) The
inhibition of activation of NF-?B and the kinases may provide part of the
molecular basis for the anti-inflammatory and anticarcinogenic effects of
silymarin.(33) Silymarin potently suppressed both NF-?B-DNA binding
activity and its dependent gene expression induced by okaidic acid in the
hepatoma cell line Hep G2. (34) In addition, silymarin inhibits COX-2 and
IL-1α.(24)
Gastric Ulcer Protective
Effects
Oral administration of silymarin to rats prevented
gastric ulceration induced by cold-restraint stress.(35) Gastric secretion
volume and acidity were not affected, but histamine concentration was
significantly decreased. It was suggested that the anti-ulcerogenic effect
of silymarin may be related to inhibition of enzymic peroxidation by the
lipoxygenase pathway.(35) The protective effect of silymarin on gastric
injury induced in rats by ischaemia-reperfusion and its effects on mucosal
myeloperoxidase has been compared with that of allopurinol.(36) The mean
ulcer indexes (4.75, 4.50 and 3.63 ui, respectively) of rats treated with
25, 50 and 100 mg/kg silymarin were significantly lower than in control
rats, although allopurinol was considerably more potent (2.3 ui; 100
mg/kg).(36)
Other Effects
Silymarin has been
shown to prevent alloxan-induced diabetes mellitus in rats, possibly due
to its antioxidant activity and increases in plasma and pancreatic
glutathione concentrations.(37)
It has been reported that Silybum
marianum and silymarin beneficially affect skin elasticity. A
phospholipid-silymarin complex (Silymarin-Phytosome) evaluated for its
topical effects against croton oil dermatitis in mice and UV-induced
erythema in humans showed reduction of oedema and inhibition of
myeloperoxidase activity.(38) A standardised extract of S. marianum
significantly inhibited porcine elastase in vitro.(39) An 80% ethanol
extract of S. marianum aerial parts showed activity against Bacillus
subtilis, Staphylococcus aureus, Streptococcus haemolyticus, Escherichia
coli, Klebsiella pneumoniae, Proteus mirabilis, Pseudomonas aeruginosa and
Salmonella typhi.(40)
Clinical Studies
Clinical
trials with milk thistle preparations have focused on their use in
alcoholic liver disease, cirrhosis and acute viral and chronic hepatitis.
However, several trials have included patients with liver disease of
different aetiology, e.g. alcoholic and non-alcoholic cirrhosis. There is
also interest in the use of silymarin in toxin- and drug-induced
hepatitis, for example following ingestion of the death cap mushroom A.
phalloides.
A randomised, double-blind, placebo-controlled,
multicentre trial involving 200 alcoholic patients with histologically or
laparoscopically proven liver cirrhosis investigated the effects of
administration of silymarin (150 mg) three times daily.(41) The results
indicated that silymarin had no effect on survival and the clinical course
in these patients: 125 patients (silymarin n = 57 and placebo n = 68)
completed the two-year study period, during which 29 died (n = 15 and 14
for silymarin and placebo, respectively; no statistically significant
difference).
In a randomised, double-blind, placebo-controlled
trial, patients with alcoholic (n = 91) or non-alcoholic (n = 79)
cirrhosis received silymarin (140 mg) three times daily or placebo for two
years.(42) The four-year survival rate was significantly higher in
silymarin-treated patients than in placebo recipients (58 versus 39%,
respectively, p = 0.036). Subgroup analysis indicated that the effect of
silymarin on mortality was more pronounced in those patients with
alcoholic cirrhosis.
Another randomised, double-blind,
placebo-controlled trial carried out over four years reported a
significantly higher survival rate in patients with alcoholic cirrhosis
treated with silymarin (420 mg) daily compared with placebo recipients,
although the effect in patients with non-alcoholic cirrhosis was less
marked.(43)
Other controlled trials have investigated the effects
of silymarin in patients with alcohol-related liver damage. Several of
these,(44,45) but not all,(46) reported statistically significant benefits
with silymarin, e.g. on serum transaminases, compared with
placebo.(1)
In a randomised controlled trial, 60 patients with
diabetes caused by alcoholic liver cirrhosis received silymarin (600
mg/day) or no silymarin treatment for six months.(47) At the end of the
study period, the mean values for fasting blood glucose, daily blood
glucose, daily glycosuria, glycosylated haemoglobin, daily insulin
requirement, malondialdehyde and glucagon-stimulated C peptide were
significantly lower in silymarin-treated patients than in those who did
not receive silymarin treatment.
A pilot study involving 20
patients with chronic active hepatitis randomised to receive a
silybin-phosphatidylcholine complex preparation (IdB1016; Silipide) (240
mg) twice daily or placebo for seven days reported significant reductions
in the mean serum concentrations of aspartate aminotransferase (AST),
alanine aminotransferase (ALT), ?-glutamyltranspeptidase (GGT) and total
bilirubin in silybin complex-treated patients compared with values in
placebo recipients.(48) The same preparation has been reported to reduce
serum concentrations of liver enzymes (AST and ALT) in 65 patients with
chronic persistent hepatitis in a randomised placebo-controlled
trial.(49)
The hepatoprotective effects of silymarin in 222 de novo
tacrine-treated patients with mild to moderate dementia of the Alzheimer
type were investigated in a randomised, double-blind (for silymarin),
placebo-controlled, multicentre, 12-week trial.(50) Patients received
tacrine plus silymarin (420 mg/day) (n = 110) or tacrine plus placebo (n =
112); silymarin (and placebo) were initiated one week before tacrine (40
mg/day for six weeks then 80 mg/day for six weeks). An intention-to-treat
analysis indicated that there was no difference in serum ALT
concentrations between the two groups, but that silymarin-treated patients
experienced significantly fewer gastrointestinal and cholinergic
side-effects without any impact on cognitive status than did placebo
recipients.(50)
The effects of silymarin in preventing psychotropic
drug-induced hepatic damage have been investigated in a randomised,
double-blind, placebo-controlled trial.(51) Sixty women aged 40-60 years
who had been taking phenothiazines or butyrophenones for at least five
years and who had AST and ALT activity twice normal values were randomised
to continued treatment with psychotropic agents or suspension of treatment
and to silymarin (800 mg/day) or placebo for 90 days. The findings
indicated that treatment with silymarin reduced the lipoperoxidative
hepatic damage associated with prolonged administration of butyrophenones
and phenothiazines and that the protective effect was greater when
treatment with these psychotropic agents was suspended for three
months.(51)
There have been numerous case reports, many of which
report favourable outcomes, on the therapeutic use of silymarin and
silibinin, usually given in combination with standard treatment, in
poisoning caused by ingestion of the death cap mushroom A. phalloides,
although there are no controlled trials in this indication.(1,51-54,G55)
Silibinin is usually given intravenously and case reports have indicated
that early administration appears to be
important.(55,56)
Pharmacokinetics
Studies of
the pharmacokinetics of silymarin and its components and of a
silibinin-phosphatidylcholine complex preparation (IdB 1016; Silipide) in
both healthy volunteers and patients with cirrhosis and those who have
undergone cholecystectomy have been reviewed.(1,G50 G55) Approximately
20-50% of silymarin is absorbed following oral administration and
approximately 80% of the dose, whether administered orally or
intravenously, is excreted in the bile.(57) Studies in healthy volunteers
have reported an elimination half-life of approximately 6 hours following
administration of single doses of silymarin corresponding to approximately
240 mg silibinin.(58,59) Other studies have compared the pharmacokinetics
of different silymarin preparations and shown statistically significant
differences in bioavailability.(60,61)
The bioavailability of a
silybin-phosphatidylcholine complex preparation (IdB 1016) has been shown
to be several times greater than that of silymarin in single-dose studies
involving healthy volunteers(62) and patients with hepatic cirrhosis.(63)
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| | | Research | | | "Milk Thistle and Nerve Regrowth"
"Milk Thistle: Hangover Buster May Cure You of Cancer"
"Milk Thistle Could Fight Prostate Cancer"
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| | | Precautions / Contraindications | | | Milk thistle is contra-indicated for individuals with hypersensitivity to
species of Asteraceae.
Don't try to self-diagnose or self-treat a
liver problem. Such ailments require the attention of a medical
professional who can closely monitor your care.
Avoid alcohol-based
tinctures of milk thistle. Some of these contain considerable amounts of
alcohol, which can damage the liver over time.
Pregnancy and
Lactation
In view of the lack of toxicity data, use of milk
thistle preparations during pregnancy and lactation should be avoided
unless the expected benefit is thought to outweigh any unknown risks to
the fetus.
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| | | Interaction with Medications | | | If you are taking the drug Indinavi® to treat advanced HIV or AIDS,
consult your doctor before taking milk thistle, an herb which may decrease
the effectiveness of this drug.
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| | | Possible Side Effects | | | Milk thistle extract is virtually devoid of any side effects and may be
used by most people, including pregnant and breast-feeding women. In fact,
it has been recommended as a treatment for itching due to poor gallbladder
function during pregnancy. Since silymarin stimulates liver and
gallbladder activity, it may have a mild, transient laxative effect in
some people. This will usually cease within two to three
days.
There is one case report of a 57-year-old Australian woman
experiencing several episodes of nausea, abdominal pain, vomiting and
weakness after taking a milk thistle preparation. This case is so
atypical, however, that the Adverse Drug Reactions Advisory Committee of
Australia questioned whether the product taken might not have contained
other herbs or additives that could be responsible for the adverse
reaction.
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| | | Dosage | | | Fruit: Crude drug 12-15 g daily in divided doses (equivalent to
silymarin 200-400 mg daily).
Herb: Approximately 1.5 g of
finely chopped material as a tea, two or three cups daily.
The
doses of silymarin used in clinical trials have ranged from 280 to 800
mg/day (equivalent to milk thistle extract 400-1140 mg/day standardised to
contain 70% silibinin).(3)
For hepatic disorders, doses of up to
140 mg (equivalent to 60 mg silibinin) two or three times daily have been
suggested. According to research and clinical experience, improvement
should be noted in about eight to twelve weeks. For people with chronic
liver disease, milk thistle extract may be considered a long-term therapy.
For those who prefer, 12-15 grams of milk thistle dried fruits can be
ground and eaten or made into a tea. This should not be considered
therapeutic for conditions of the liver, however.
To work as
effectively as indicated in dozens of clinical trials, milk thistle needs
to be correctly prepared and standardized. Choose a supplement
standardized to contain 70% to 80% silymarin, the active ingredient. This
high concentration of silymarin is needed to ensure that a sufficient
amount will reach the bloodstream and eventually the liver.
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| | | References | | | 1. Morazzoni P, Bombardelli E. Silybum marianum (Carduus marianus).
Fitoterapia 1995; 66: 3-42.
2. Awang D. Milk thistle. Can Pharm J 1993;
403-404, 422.
3. Pepping J. Milk thistle: Silybum marianum. Am J
Health-Syst Pharm 1999; 56: 1195-1197.(PubMed)
4. Leng-Peschlow E.
Properties and medical use of flavolignans (silymarin) from Silybum
marianum. Phytother Res 1996; 10: S25-26.
5. Pascual C et al. Effect of
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flavolignans upon low density lipoprotein oxidizability in vitro.
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11. Valenzuela A, Garrido A.
Biochemical basis of the pharmacological action of the flavonoid silymarin
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13. Kropacova K et al. Protective and therapeutic
effect of silymarin on the development of latent liver damage. Radiat Biol
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14. Drozdzik M et al. Effect of
silymarinphospholipid complex on the liver in rabbits maintained on a
high-fat diet. Phytother Res 1996; 10: 406-409.
15. Krecman V et al.
Silymarin inhibits the development of diet-induced hypercholesterolemia in
rats. Planta Med 1998; 64: 138-142.(PubMed)
16. Skottova N, Krecman V.
Silymarin a potential hypocholesterolaemic drug. Physiol Res 1998; 47:
1-7.(PubMed)
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salt secretion in the rat. Biochem Pharmacol 2000; 59: 1015-1022.(PubMed)
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19. Bokemeyer C et al.
Silibinin protects against cisplatin-induced nephrotoxicity without
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on experimental cyclosporine nephrotoxicity. Renal Failure 1998; 20:
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silybin on gynaecological malignancies: synergism with cisplatin and
doxorubicin. Eur J Cancer 1996; 32A: 877-882.(PubMed)
22. Zi X et al.
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24. Zhao J et al. Significant inhibition by the
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13-acetate caused modulation of anti oxidant and inflammatory enzymes and
cyclooxygenase 2 and interleukin-1 alpha expression in SENCAR mouse
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25. Lahiri-Chatterjee M et al. A
flavonoid antioxidant, silymarin, affords exceptionally high protection
against tumour promotion in the SENCAR mouse skin tumorigenic model.
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26. Zi X et al. A flavonoid
antioxidant, silymarin, inhibits activation of erbB1 signaling and induces
cyclin-dependent kinase inhibitors, G1 arrest and anticarcinogenic effects
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27. Zi X, Agarwal R. Modulation of mitogen-activated
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528-536.(PubMed)
28. Zi X et al. Anticarcinogenic effect of a flavonoid
antioxidant, silymarin, in human breast cancer cells MDA-MB468: induction
of G1 arrest through an increase in Cip1/p21 concomitant with a decrease
in kinase activity of cyclin-dependent kinases and associated cyclins.
Clin Cancer Res 1998; 4: 1055-1064.(PubMed)
29. Bhatia N et al.
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30. Zi X et al. Silibinin decreases
prostate-specific antigen with cell growth inhibition via G1 arrest,
leading to differentiation of prostate carcinoma cells: implications for
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31. Zhao J, Agarwal R. Tissue distribution of
silibinin, the major active constituent of silymarin, in mice and its
association with enhancement of phase II enzymes: implications in cancer
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32. De La
Puerta R et al. Effect of silymarin on different acute inflammation models
and in leukocyte migration. J Pharm Pharmacol 1996; 48:
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33. Manna SK et al. Silymarin suppresses TNF-induced
activation of NF-kappaB, c-Jun N-terminal kinase and apoptosis. J Immunol
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34. Saliou C et al. Selective inhibition
of NF-kappaB activation by the flavonoid hepatoprotector silymarin in
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Our thanks to the following
information resources: MedicinesComplete.com, American Botanical
Council (Herbalgram.org), WholehealthMD.com, Botanical.com, Vitacost.com,
Purplesage.org, Skyeherbals.com.
Browse Sections | View Milk Thistle products
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| | 59 total products | | | Milk Thistle (Read all about Milk Thistle.)
Botanical Latin Name: Carduus marianus, Silybum marianum
Plant Part: Fruits (referred to as seeds), herb | |
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Milk Thistle - Health - Milk Thistle Leaf Tea
25 tea bags
11.41 US
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Milk Thistle - Health - Milk Thistle Leaf Tea
50 tea bags
17.07 US
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Milk Thistle - Health - Milk Thistle Seed - Liquid Extract / Tincture (1:5) - Strawberry Flavored Alcohol-Free
1 fl oz / 30 mL
Powerful Liver Support!
9.55 US
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Milk Thistle - Health - Milk Thistle Seed - Salve / Ointment
2 oz / 57 g
15.76 US
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Milk Thistle - Health - Milk Thistle Seed - Cream
2 oz / 57 g
13.74 US
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Milk Thistle - Health - Milk Thistle Seed - Liquid Extract / Tincture (1:5) - Chocolate Flavored Alcohol-Free
1 fl oz / 30 mL
Powerful Liver Support!
9.55 US
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Milk Thistle - Health - Milk Thistle Seed - Liquid Extract / Tincture (1:5) - Vanilla Flavored Alcohol-Free
1 fl oz / 30 mL
Powerful Liver Support!
9.64 US
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Milk Thistle - Health - Milk Thistle Seed - Liquid Extract / Tincture (1:5) - Mint Flavored Alcohol-Free
1 fl oz / 30 mL
Powerful Liver Support!
9.55 US
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Milk Thistle - Health - Milk Thistle Leaf Powder
4 oz / 114 g
16.66 US
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Milk Thistle - Health - Milk Thistle Leaf Powder
1 oz / 28 g
9.24 US
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Milk Thistle - Health - Milk Thistle Herb Powder
4 oz / 114 g
19.34 US
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Milk Thistle - Health - Milk Thistle Herb Powder
1 oz / 28 g
9.96 US
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These statements have not been evaluated by the Food and Drug Administration (FDA). Products are intended to support general well being and are not intended to treat, diagnose, mitigate, prevent, or cure any condition or disease. If conditions persist, please seek advice from your medical doctor.
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